Accounts Receivable Specialist (Heights)

Houston Area Community Services - Houston, TX

Full-time

Houston, TX

Ambulatory Health Care Services

About the position

The Accounts Receivable (A/R) Specialist plays a crucial role in managing the company's third-party medical claims processing. This position is essential for ensuring that patients and office staff receive accurate and timely information regarding insurance claims, authorizations, statements, and other billing issues. The A/R Specialist will be responsible for submitting and following up on medical claims for various entities, including Managed Care Organizations (MCO), Medicaid, Medicare, Other Federal programs, Private Insurance, and Workers Compensation. This role requires a keen attention to detail and a strong understanding of the medical billing process to effectively navigate the complexities of insurance claims. In this position, the A/R Specialist will work diligently on unpaid claims, utilizing follow-up work queues to ensure that all claims are addressed promptly. The specialist will be tasked with rebilling and appealing claims within a 30-45 day window following a denial date, which is critical for maintaining the company's revenue cycle. Additionally, the A/R Specialist will provide insurance companies with necessary medical records or documents upon request, ensuring compliance with all regulatory requirements. The role also involves identifying payer trends or issues and reporting these findings to leadership for resolution. The A/R Specialist will bill patients for non-covered services and manage secondary and tertiary insurance billing after primary payments have been received. Assisting patients with self-pay balances is another key responsibility, requiring excellent communication skills and a customer-focused approach. Throughout all tasks, the A/R Specialist must maintain high standards of productivity and quality, contributing to the overall efficiency of the revenue cycle and billing department. Other tasks may be assigned by the Director of Revenue Cycle and Billing as needed, making adaptability and a willingness to learn essential traits for success in this role.

Responsibilities

• Work unpaid claims in follow-up work queues.
• Rebills/appeals claims within 30-45 days of denial date.
• Provide insurance companies with needed medical records or documents when requested.
• Identifies payer trends or issues and reports to leadership for resolution.
• Bill patients for non-covered services.
• Bill secondary and tertiary insurances after primary payment.
• Assist patients with self-pay balances.
• Always maintain proper work standards in productivity and quality.
• Other tasks as assigned by the Director, Revenue Cycle and Billing.

Requirements

• High School Diploma required.
• 2 years billing experience.
• 5 years collection experience.
• FQHC collection experience preferred.

Benefits

• Generous Paid Time Off (11 paid holidays per year, 2 Floating Holidays per year, 14 paid Vacation days per year, 4 hours per month of accrued Sick days)
• Medical, Dental, and Vision
• 401K match up to 4%
• Company paid Life Insurance
• Company paid Short Term and Long-Term Disability
• Employee Assistance Program